CINCINNATI, July 28 /PRNewswire/ --Ethicon Endo-Surgery held a scientific symposium at the 26th Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS) where four leading researchers shared innovative thinking coupled with mounting data about how the biochemical and endocrine effects of metabolic surgery is shaping research, treatment and health care policy for patients battling the co-morbid conditions associated with obesity, particularly Type 2 diabetes.

Moderating the discussion about the biology, mechanisms, and science behind metabolic surgery was Philip Schauer*, MD, Director of the Cleveland Clinic Bariatric and Metabolic Institute. Other participants included:

Randy J. Seeley*, Ph.D., Professor of Psychiatry and Associate Director of the Metabolic Disease Institute at the University of Cincinnati College of Medicine

"This forum highlights the important role innovative thinking and collaboration play in the fight against obesity - a fight that will require treatment options beyond surgical and pharmaceutical solutions available today to win," said Karen Licitra, Company Group Chairman, Ethicon Endo-Surgery, Inc., who introduced the session. "Ethicon Endo-Surgery is committed to supporting research into the underlying metabolic effect bariatric surgery has on co-morbid conditions, such as Type 2 diabetes, heart disease and cancer. We know bariatric surgery is effective but we don't know how or why. We believe this basic science will help us better understand which patients are likely to respond to different therapies, as well as help us develop new therapies that are less invasive and more cost-effective."

Dr. Seeley discussed his research on the biology of obesity and the role of the central nervous system in regulating food intake, body weight and fat tissue. He said new treatments for Type 2 diabetes and obesity may be able to alter the function of fat tissue or change the signaling that takes place between fat tissue and the brain to better regulate satiety and the storage of calories. Dr. Seeley is the recipient of the 2009 American Diabetes Association Outstanding Scientific Achievement Award.

Dr. Kaplan presented on "The Remarkable Physiology of Metabolic Surgery." He discussed potential mechanisms by which metabolic surgery affects Type 2 diabetes. He cited three primary ways: 1. weight loss, 2. decreased nutrient intake or 3. changes in GI physiology or signaling independent of weight loss and decreased nutrient intake, but that this last mechanism appears to be limited to gastric bypass. He said gastric bypass has the ability to reset the body's energy "set point" at a lower body mass index (BMI) and that the central nervous system plays a large role in the metabolic effects and weight loss from the surgery.

Dr. Rubino discussed metabolic surgery as a primary treatment for Type 2 diabetes and presented data on diabetes remission after metabolic surgery even before weight loss occurs. He asserted that remission results from more than gastric restriction and weight loss and that the surgically rearranged intestine and other factors related to the proximal bowel may contribute to the pathophysiology of type 2 diabetes. He raised the question if BMI alone in Type 2 diabetes patients should not be a determinant for who has access to metabolic surgery, as BMI may not enable consideration of other critical patient specific health factors (e.g., uncontrolled/poorly controlled diabetes). Dr. Rubino indicated that these data support the need for additional research and dialogue between appropriate healthcare stakeholders.

Dr. Schauer summed up the session with a review of the American Diabetes Association (ADA) 2009 Treatment Guidelines that for the first time said, "bariatric surgery should be considered for adults with BMI >/- 35 kg/m2 and type 2 diabetes, especially if the diabetes is difficult to control with lifestyle and pharmacologic therapy."He pointed out that the ADA Guidelines stated that "bariatric surgery has been shown to lead to near or complete normalization of glycemia in 55-95% of patients with type 2 diabetes, depending on the surgical procedure."

"Diabetes is a chronic progressive disease," said Dr. Schauer. "BMI is easy to measure and a pretty good indication of the percentage of body fat, so we should just use it as a marker but not a rule."

About Ethicon Endo-Surgery

Ethicon Endo-Surgery, Inc., a Johnson & Johnson company, develops and markets advanced medical devices for minimally invasive and open surgical procedures, focusing on procedure-enabling devices for the interventional diagnosis and treatment of conditions in general and bariatric surgery, as well as gastrointestinal health, gynecology and surgical oncology.

Ethicon Endo-Surgery Commitment to Metabolic Surgery

In 2008, Ethicon Endo-Surgery partnered with the University of Cincinnati (UC) through a significant three-year investment to gain a better understanding of the basic biology behind obesity. Ethicon Endo-Surgery engineers and UC researchers will work together to find new solutions for treating obesity and related conditions, including diabetes.

In 2009, the company also signed a three-year research contract with Massachusetts General to deconstruct and understand the how and why behind the outcomes of the Roux-en-Y gastric bypass procedure.

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